Active NPI
Michael Simonian
- Behavior Analyst
- Roseville, CA
National Provider Identifier
1992273460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-22-60128
- Practice address
- 214 Estates Dr Ste a
Roseville, CA 95678-2353 - Phone
- (916) 749-4646
- NPI assigned
- Nov 2, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-18-61380 | CA | |
| Behavior Analyst | 103K00000X | 1-22-60128 | CA | Primary |
Addresses
Primary practice location
214 Estates Dr Ste a
Roseville, CA 95678-2353
Mailing address
214 Estates Dr Ste a
Roseville, CA 95678-2353
Phone (916) 749-4646
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RBT-18-61380 | Other | CA | BEHAVIOR TECH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-18-61380 | CA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Building Blocks Behavior Consultants | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Roseville, CA
- NPI 1417245218
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658275200000",
"number": "1992273460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 ESTATES DR STE A",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956782353",
"telephone_number": "916-749-4646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "214 ESTATES DR STE A",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956782353",
"telephone_number": "916-749-4646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMONIAN",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-02",
"last_updated": "2022-07-20",
"certification_date": "2022-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CA",
"license": "RBT-18-61380",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-22-60128",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEHAVIOR TECH",
"identifier": "RBT-18-61380",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roseville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.